Tracheotomy may be required in the following situations:

1. Emergencies: In case of emergency airway obstruction caused by a severe allergic reaction, choking, trauma or foreign bodies.
2. Need for Long Term Ventilation: In patients requiring mechanical ventilation, a tracheotomy can be performed instead of prolonged intubation. This improves patient comfort and is less irritating to the airways.
3. Upper Respiratory Tract Obstruction: For obstructions caused by cancer, infection (for example, epiglottitis) or other causes.
4. Diseases such as sinusitis or laryngitis: In such cases, a tracheotomy may be needed so that air can flow freely.
5. Chronic Respiratory Diseases: For example, in the course of treatment for conditions such as emphysema, bronchitis or other chronic obstructive pulmonary diseases.

Tracheotomy is usually performed under general anaesthesia or sometimes under local anaesthesia. The procedure steps are generally as follows:

1. Preparation: The patient is positioned and the area is sterilised.
2. Incision: A small incision is made in the neck, usually between the Adam's apple (the prominence of the larynx) and the second or third tracheal rings.
3. Tracheal Opening: The trachea is opened at the incision site and a tracheostomy tube is inserted. This tube is used to ensure airflow and keep the airways open.
4. Insertion: Once the tube is in place, the tube is tied and secured to allow airflow from the outside.

Patients are usually kept under observation after tracheotomy. Some points to be considered after the procedure are as follows:

• Tube Care: Regular maintenance and cleaning of the tracheostomy tube should be ensured. Cleaning the mucus accumulated in the tube reduces the risk of infection.
• Nutrition: During the first few days, the patient is usually fed intravenously. Afterwards, oral feeding can be started.
• Physical Activity: Depending on the patient's recovery process, it is recommended to gradually return to physical activities.
• Monitoring: The condition of the respiratory tract and signs of infection should be monitored regularly.

Although the tracheotomy procedure is generally safe, it may involve some risks and complications:

• Infection: Infection may develop at the tracheostomy site.
• Bleeding: Bleeding may occur at the incision site.
• Tracheal Damage: Damage to the trachea or surrounding tissues during the procedure.
• Tube Placement Problems: Incorrect placement or dislodgement of the tube.
• Long-term Complications: The tracheostomy tube may cause irritation or narrowing of the airways with prolonged use.

In the long term after tracheotomy, there are some important points that patients should pay attention to:

• Allergies and Infection Risks: The tracheostomy tube can make you more susceptible to infection and allergies. It is important that patients are aware of this issue.
• Rehabilitation: Respiratory therapy or physiotherapy may be required to support the patient's healing process.
• Regular check-ups: Regular follow-ups by healthcare professionals are important to prevent complications and assess respiratory status.

Tracheotomy is a life-saving procedure in emergency situations, but requires careful monitoring and care. Appropriate management and follow-up for each patient is critical to prevent complications.